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Hypertension: Dangerous yet not taken seriously by many

BY Dr JOHANNES MARISA

Many people have succumbed to hypertension, directly or indirectly yet they could have saved themselves from the condition. The World Health Organisation estimates that 1.13 billion people worldwide have hypertension and at least 7.6 million people die from hypertension annually, a figure surely higher than all the victims of Covid-19 that has claimed about 2.7 million people so far.

Many people ignore the condition and even default on medication, but the complications are quite devastating. Renal failure, strokes and heart failure are all serious complications which are claiming many people daily.

So many deaths can be averted by observing healthy diet and living as well as taking medication as prescribed by clinicians. Lately, poorly-controlled hypertension has been associated with increased mortality from Covid-19.

This calls for all of us to make sure we do not move around with high blood pressure.

Symptoms

Most patients with high blood pressure do not exhibit symptoms or signs even if blood pressure readings reach dangerous levels.

However, those who show symptoms or signs can have some of the following:

Persistent headache

Tiredness

Poor vision

Nose bleeding

Swelling of legs

Shortness of breath

NB**Please note that more symptoms or signs will appear with complications of hypertension. Renal failure may present with poor urine output or no urine at all, swelling of the body which may include the face, while heart failure may present with shortness of breath, swelling of the limbs, fluid in the abdomen and fatigability, to mention just a few symptoms.

Causes of hypertension

There are two types of hypertension. It always surprises me when many patients argue that they cannot take blood pressure medication because they are still young yet the readings are alarmingly high.

Primary hypertension

This is the type where there is no identifiable cause. This type tends to develop gradually over many years.

Secondary hypertension

Blood pressure is caused by an underlying condition. This type of hypertension can appear suddenly. Various conditions or medications can cause such hypertension and these include the following:

Kidney disease

Thyroid problems, for example, thyrotoxicosis

Addison’s disease

Pheochromocytoma

Congenital blood vessel problems

Obstructive sleep apnea

Certain medications like birth control pills, cold remedies, decongestants and steroids with mineralocorticoid activity

Risk factors

High blood pressure has many risk factors which include the following:

Age — Risk increases with age as those above 60 years are more prone

Race — Is particularly more common in people of African origin, often developing at earlier ages than what happens among whites.

Family history — High blood pressure tends to run in families. The whole family may have high blood pressure and complications may take the same course.

Being overweight or obese — The more the weight, the higher the risk of high blood pressure as more blood is required in all the tissues of your body.

Physical inactivity — Those who lead a sedentary lifestyle have higher risk of developing high blood pressure.

Smoking — Smoking can increase blood pressure as chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow and increase your risk of heart disease.

Alcohol — Heavy drinking can damage your heart

Stress — High levels of stress can lead to a temporary increase in blood pressure

Certain chronic conditions — Conditions like renal failure, diabetes, sleep apnea and thyroid disease can increase the chances of developing hypertension.

Complications

The excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels as well as your organs. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage. The following complications have been quite common in Zimbabwe judging by what we see in our practice:

Stroke — Quite common among the populace with resultant weakness usually of one side of the body. Many people have lost their lives to strokes because of uncontrolled hypertension.

Heart failure — Heart can struggle to pump blood because of damages as a result of high blood pressure.

Renal failure — Weakened and narrowed blood vessels in your kidneys can damage the kidneys and prevent them from functioning properly. Many people have lost kidney function with resultant dialysis, which is unfortunately beyond affordability of the general populace.

Aneurysm — Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be catastrophic.

Dementia — Narrowed or blocked arteries can limit blood flow to the brain, leading to vascular dementia.

Vision loss — Thickened, narrowed or torn blood vessels can cause loss of vision.

Be cautious about hypertension. It is a common condition that contributes to a lot of deaths in our country. We continue to lose many patients daily yet they could have been saved from the jaws of deaths had they been taking their drugs religiously. Save the next person today, advise them on taking blood pressure medication!

  • Dr Johannes Marisa is a medical practitioner who can be accessed on doctormarisa@gmail.com.

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